Kegel Exercises: Benefits, Technique, and When to Seek Help

How to Do Kegels?

Kegel exercises, or pelvic floor muscle exercises, involve repeatedly contracting and relaxing the muscles that support your bladder, bowel, and uterus (in women), to strengthen them and improve their function.

What Are Kegel Exercises?

Kegel exercises are a simple yet powerful form of exercise designed to strengthen the pelvic floor muscles. These muscles form a sling-like structure at the base of your pelvis, extending from the pubic bone at the front to the tailbone at the back. They play a crucial role in supporting your internal organs, controlling bladder and bowel function, and contributing to sexual health. When these muscles are weak, it can lead to issues such as urinary or fecal incontinence, pelvic organ prolapse, and decreased sexual sensation.

• The Pelvic Floor Muscles: Think of your pelvic floor as a hammock that holds your pelvic organs in place. It's composed of several layers of muscles, including the levator ani and coccygeus muscles, which work synergistically to provide support and control.

Who Benefits from Kegel Exercises?

While often associated with women, Kegel exercises are beneficial for anyone experiencing or at risk of pelvic floor dysfunction.

• For Women:

  • Pregnancy and Childbirth: Strengthening the pelvic floor before and after childbirth can help prepare the body for delivery and aid in postpartum recovery, reducing the risk of incontinence and prolapse.
  • Urinary Incontinence: Effective for treating stress incontinence (leaking urine when coughing, sneezing, laughing, or exercising) and urgency incontinence (a sudden, strong urge to urinate).
  • Pelvic Organ Prolapse: Helps provide support to organs that may have descended into the vagina (e.g., bladder, uterus, rectum).
  • Sexual Function: Can enhance sensation and improve orgasmic potential.

• For Men:

  • Post-Prostatectomy: Often recommended for men who have undergone prostate surgery, which can weaken the pelvic floor and lead to urinary incontinence.
  • Urinary Incontinence: Helps manage various types of male incontinence.
  • Erectile Dysfunction: May improve erectile function and ejaculatory control.

How to Locate Your Pelvic Floor Muscles

The most critical step in performing Kegels correctly is identifying the right muscles. Many people mistakenly engage their abdominal, gluteal, or thigh muscles, which can be counterproductive.

• For Women:

  • Stop Urine Flow Midstream: While urinating, try to stop or slow the flow of urine. The muscles you use to do this are your pelvic floor muscles. Do not make this a regular practice, as it can interfere with proper bladder emptying. It's just for identification.
  • Insert a Clean Finger: Lie down and insert a clean finger into your vagina. Try to squeeze your vaginal muscles around your finger. You should feel a gentle squeeze and lift.
  • Imagine Lifting: Think of trying to stop passing gas, or imagine lifting something up into your vagina.

• For Men:

  • Stop Urine Flow Midstream: Similar to women, try to stop or slow the flow of urine. This helps identify the muscles. Again, do not make this a regular practice.
  • Lift the Scrotum/Penis: Imagine lifting your testicles or the base of your penis upwards without moving your thighs, buttocks, or abdominal muscles.
  • Stop Passing Gas: Try to prevent yourself from passing gas. The muscles you clench are your pelvic floor muscles.

• Important Note: If you're not sure you've found the right muscles, or if you feel strain in your abdomen, glutes, or thighs, stop and try again. It's better to do fewer correct Kegels than many incorrect ones.

Step-by-Step Guide to Performing Kegels

Once you've confidently located your pelvic floor muscles, you can begin your Kegel exercise routine.

• Preparation:

  • Empty your bladder: Always perform Kegels with an empty or nearly empty bladder.
  • Find a comfortable position: Start by lying on your back with your knees bent and feet flat on the floor. As you gain proficiency, you can try them while sitting or standing.

• The Basic Contraction:

  1. Inhale and Relax: Take a deep breath and fully relax your pelvic floor muscles.
  2. Exhale and Contract: As you exhale, gently but firmly squeeze and lift your pelvic floor muscles. Imagine you are trying to stop both urine flow and passing gas simultaneously, or as if you are lifting a marble up into your body.
  3. Hold: Hold the contraction for 3-5 seconds. Focus on isolating only the pelvic floor muscles; avoid tensing your abs, glutes, or inner thighs.
  4. Release: Slowly and completely relax your pelvic floor muscles for 5-10 seconds. It's crucial to allow for full relaxation between contractions to prevent muscle fatigue and promote proper blood flow.

• Breathing: Maintain normal, steady breathing throughout the exercise. Do not hold your breath.

• Repetitions and Sets:

  • Aim for 10-15 repetitions per set.
  • Perform 3 sets per day.
  • As your strength improves, you can gradually increase the hold time to 8-10 seconds per contraction.

• Common Mistakes to Avoid:

  • Bearing Down: Do not push down as if having a bowel movement. This can weaken the pelvic floor.
  • Using Other Muscles: Avoid squeezing your abdominal muscles, glutes, or inner thighs. If these muscles are working, you're not isolating the pelvic floor.
  • Holding Your Breath: Breathe normally throughout the exercise.
  • Overdoing It: More isn't always better. Overtraining can lead to muscle fatigue or pain. Stick to the recommended sets and reps.

Incorporating Kegels into Your Daily Routine

The beauty of Kegel exercises is that they can be performed almost anywhere, anytime, once you master the technique.

• Consistency is Key: Daily practice is essential for seeing results. Make it a habit.
• Various Positions: Once proficient, practice them while sitting at your desk, standing in line, or lying in bed.
• Functional Integration: To train your pelvic floor for real-life situations, try engaging your muscles just before you cough, sneeze, laugh, lift something heavy, or jump. This "pre-squeeze" can help prevent leakage.

When to Expect Results

Consistency is paramount. You may start to notice improvements in bladder control or other symptoms within a few weeks to a few months (typically 4-6 weeks for initial changes, up to 3-6 months for significant improvement). The benefits are cumulative, so continued practice is necessary to maintain strength.

When to Seek Professional Guidance

While Kegels are generally safe to perform on your own, sometimes professional guidance is beneficial, or even necessary.

• Difficulty Identifying Muscles: If you struggle to locate your pelvic floor muscles or are unsure if you're performing the exercises correctly, seek help.
• No Improvement: If you've been consistently doing Kegels for several months and haven't seen any improvement in your symptoms.
• Pain or Discomfort: If you experience any pain during or after Kegel exercises.
• Pelvic Floor Physical Therapist: A specialized physical therapist, often called a pelvic floor physical therapist, can provide personalized guidance. They use techniques like biofeedback (which uses sensors to show you on a screen if you're contracting the right muscles) or electrical stimulation to help you identify and strengthen your pelvic floor effectively. They can also assess for hypertonic (overly tight) pelvic floor muscles, which can cause pain and dysfunction, and require a different approach than strengthening.